This technique has been practised by doctors
for thousands of years and a great deal of research has been carried out to test its safety. The Royal College of Obstetricians and Gynaecologists recommends that: "All women with an uncomplicated singleton breech pregnancy at 36 weeks should be offered external cephalic version."
ECV can be carried out at any point from 36 weeks of pregnancy; there is no upper limit. Sometimes, it is even carried out at the beginning of labour, if the waters haven't already broken.
The procedure will be carried out in hospital, where there is equipment to
monitor your baby's heartbeat and
ultrasound to check your baby's position. You will be given a drug to make the muscles of your uterus relax. If you are
rhesus negative, you will have an injection of anti-D. You will not need to have a general anaesthetic.
Because ECV is often successful, a policy of offering it to every woman with a breech baby means that there will be fewer caesareans for breech babies.
ECV is more likely to be successful if:
• you've had a baby before
• there is plenty of fluid around your baby
• your baby is high up/has yet to engage in your pelvis
• a drug is used to relax the muscles of the uterus
If a first attempt at ECV is unsuccessful, your doctor may discuss trying again on another day. It will depend on your individual case as to whether further attempts are worthwhile. You can find out more about ECV from the Royal College of Obstetricians and Gynaecologist's guide
Turning a breech baby in the womb: Information for you.
Turning techniques you can do at home are collectively referred to as
spontaneous cephalic version. Some studies have been carried out to see if these various methods work, but reviews of the evidence to date have been inconclusive.
You could try:
• Adopting a knee-to-chest position by kneeling on your bed with your bottom in the air and your hips flexed at slightly more than 90 degrees (don't let your thighs press against your bump). Try to keep your head, shoulders, and upper chest flat on your mattress. Maintain this position for 15 minutes every two waking hours for five consecutive days. In one study of 71 breech babies, 65 turned when their mother adopted the knee-chest position.
• Lying on your back with your hips slightly elevated and your hips and knees flexed. Gently roll from side to side for 10 minutes and repeat this manoeuvre three times a day. If you have had any
backache,
pelvic pain or
hip pain during your pregnancy, do talk to your midwife or physiotherapist before you try this.
• Moxibustion, which is a form of acupuncture. It's currently being researched to see if it could help turn breech babies. Success rates as high as around 80 per cent have been reported, but before trying it, seek advice from a qualified acupuncturist; you'll find one via the
British Acupuncture Council.
At the end of the day it might be that your baby prefers to lie in the breech position; about 5 per cent even turn back to breech position after a successful ECV. If this is the case, a
caesarean section will probably be recommended but, depending on your baby's exact position, a vaginal birth may still be possible. Read our article on breech birth and discuss the possibility of having a vaginal birth with your midwife and obstetrician.